Stroke

Ischemic small vessel disease

04/21/2008

Question:

I could not find where to ask a question about the above. My MRI on the T2 and FLAIR images showed right frontal subcortical white matter 6mm x 3mm images suggestive of moderate to severe chronic ischemic small vessel disease. I do not know what this means and cannot get a straight answer. Does this mean I am prone to have, or likely to have a stroke? I am 59 years old, my family from my grandparents down on both sides of the family have had strokes and heart attacks, died mostly from heart attacks. I have headaches and have for years. My blood pressure is fine, I do not take meds for this. My bad collesteral is high and I am taking Zetia for that, but my good collesteral is very good. I want to know what this means (a down to earth, give me no flowers) answer. I am very scared and worried. Thank you.

Answer:

I have written extensively about small vessel disease, and would refer you to previous answers as well as an associated document on this topic.

In summary, findings like this do suggest a slightly higher risk for stroke. You do have several known risk factors including a family history, a history of migraines, and high cholesterol that put you at higher risk.

You should continue to work with your doctor(s) to minimize your risk for stroke. I cannot provide a specific prediction of your risk for stroke, although there are tools available that can give you an idea about your risk. You might try this stroke risk calculator (http://stroke.ucla.edu/body.cfm?id=66). Please note that the limitations of this tool.

Please note: only your personal physician or other health professional you consult can best advise you on matters of your health based on your medical history, your family medical history, your medication history, and how information from any of these databases may apply to you. Neither University of Cincinnati (NetWellness) nor any party involved in creating, producing or delivering this web site shall be liable for any damages arising out of access to or use of this web site, or any errors or omissions in the content thereof. (More)